Where: Washington Museum of History and Industry 2700 24th Avenue East Seattle, WA

*** WE HAVE EXTENDED OUR EARLY BIRD RATE UNTIL 5:00 PM, FRIDAY, MARCH 9 ***

Health IT is transforming our healthcare system. Healthcare reform, industry consolidation, and demographic changes have spurred a significant increase in the U.S. healthcare industry’s use of technology to improve health and enhance the patient experience while trying to help control the ever-increasing cost of care. New players are emerging and cloud computing, social media, and mobile technology solutions targeting patients and healthcare providers are creating new opportunities.

Join us for our March 14 MIT Enterprise Forum and discover how NW technology entrepreneurs can identify these opportunities and succeed in the health IT market. Our panel of industry thought-leaders moderated by Rob Coppedge, Vice President of Business and Corporate Development at Cambia Health Systems, includes:

Sailesh Chutani, CEO, Mobisante

Peter Gelpi, CEO, Clarity Health

Luis Machuca, President & CEO, Kryptiq Corporation

Gwen O’Keefe, MD, Chief Medical Informatics Officer, Group Health

Our panel will provide an overview of major health IT trends, the new opportunities technology presents for both patients and healthcare providers, as well as explain how this may enable change in the traditional healthcare industry cost structure. Most importantly, our speakers will identify business opportunities and what regulatory restrictions such as HIPAA really mean for the NW technology entrepreneur community.

Audience Takeaways

During this event, you will learn:

How the health IT market has changed in the wake of healthcare reform and government investment incentives

What different types of care and cost models might look like, and what opportunities those present for entrepreneurs

Potential sources of funding for innovative health IT technologies

Approaches entrepreneurs can take to handle barriers presented by government regulations such as HIPAA

More info: http://www.elliottbaybook.com/node/events/feb11/taubesWhy We Get Fat: And What to Do About It (Knopf) is acclaimed science writer Gary Taubes’ no-beating-around-the bush examination of why so many today are seriously overweight. A three-time recipient of Science in Society Journalism Awards, and presently a Robert Johnson Foundation Investigator in Health Policy Research at the University of California, Berkeley, he builds on the strong base of material he presented in his Good Calories, Bad Calories—which Michael Pollan said was "a vitally important book, destined to change the way we think about food." Part of that thinking is seeing the problem lying in particular kinds of carbohydrates, not fats, and not in calories per se.

In that post, I said I’d follow up after having completed the book, so here’s the post I said I’d write.

The short summary is it should be an eye-opening book for anyone. Dr. Wangen has taken up this issue in a previous book entitled The Irritable Bowel Syndrome Solution as well in his clinical practice where he has become a ‘go-to’ person for those with wheat allergies, gluten intolerance and irritable bowel syndrome (IBS). Given I’ve been on the dietary fringe for some time, it’s easy for me to underestimate the extent to which this book pierces deeply entrenched notions about what’s ‘good’ and ‘healthy’ for you. Think about it, this book essentially makes the assertion that this staple of life (bread of life) should be treated more like a toxin and should only be consumed as a last resort, given its metabolic effects on the body.

As is often the case with books written by clinicians in active practice, it has more then its fair share of testimonials/case studies. While I understand this approach appeals to lots of people and makes the whole thing less dry for most, I skip over most of them. But they’re there for you if you want them.

Found his explanation of the origin of cereal grains and the differences and commonalities among them fascinating. He includes a ‘family tree’ of grains that include all the ones we find in common use today: wheat, oats, corn, rice, spelt, etc.

Having known very little about IBS, celiac disease and the like, it was enlightening to have him clearly delineate the differences among these conditions and state categorically that these ‘conditions’ only persist as long as you consume the offending item (wheat or gluten as the case may be).

The only major issue I had with the book is the repeated reference to an extremely wide range of symptoms that might lead you to consider whether you might have an allergy/intolerance. There were instances where, after I read the list, I wondered what adverse condition was left out. So that’s where I’d include a gain of salt. He also spent a lot of time describing the diagnostic methods he uses to make a determination as to what might be at the root of issues you’re seeing. Got a sense that these sections were more directed at his peers whose patients might pick up the book and ask their doctor’s about it. Wouldn’t want to leave out stuff that would clearly show you knew what you were doing since the book is likely to wind up in the hands of other physicians either directly or indirectly.

So, the bottom line is it is well worth the read if you or someone you care about has issues with wheat or gluten. It is also of interest to those who are not so wedded to our revered food staple (bread) that they might be considering giving it up to better their health.

April 19, 2010

I mean, how silly can you get. I’m spending a perfectly glorious, warm, sunny Sunday morning/afternoon in Seattle (yes, I said ‘sunny’ and ‘Seattle’ in the same sentence – in April, no less) indoors with a those who are inclined to attend an obesity conference convened by the American Society of Bariatric Physicians (ASBP). This I did of my own volition and with specific intention. I did not simply stumble upon this crew while rollerblading the Burke-Gilman Trail. If the term ‘weirdly obsessed’ comes to mind, no worries. Gary Taubes used those exact words to describe me.

But there I was. Loving it, and regretting that I hadn’t had the opportunity to spend more time with this group during their time in Seattle. For one, I had the opportunity to meet a whole host of authors whose works have greatly contributed to my thinking about diet, nutrition and wellness – without whom my current state of health and fitness would have been considerably less. I certainly would not have started this blog. The ASBP is a medical professional association (physicians, nurse practitioners, physician assistants, clinical researchers, etc.) focused on treatment and management of overweight patients. In addition, however, it has become a magnet for those who are actively seeking to re-orient our dietary priorities world-wide.

The majority of the (admittedly self-selected) clinicians who I heard speak and with whom I spoke directly, are convinced that significantly-restricted carbohydrates is the ‘front line’ of obesity treatment and prevention. This is not to say there is not a diversity of thought on many issues. One issue that engenders a great deal of discussion is the extent to which pure ‘energy balance’ contributes to lipogenesis. My sense this is an issue that will continue to rage, but I was very surprised to see a near consensus that restriction of easily digestible carbohydrates (sugars/starches) is a major contributor to obesity (more specifically, lipogenesis). Before you go ‘well, duh!’ a scant few years ago this view was literally scoffed at by anyone with a string of initials behind their name (save the very few and proud), so don’t start with the ‘everybody knows this’ stuff.

… and that’s not all. Owing to the ongoing bizarre activities of a certain Icelandic volcano, Andreas gets to enjoy a bit more of our hospitality. Perhaps a super slow/Body by Science workout this evening. Stay tuned.

Thanks to all of you for your warmth and hospitality. This weekend was just the inspiration I needed to step up my efforts. Watch out!

April 15, 2010

Well, I was able to attend the talk this morning (4/15) at the First Hill location of Swedish Medical Center in Seattle. While it was much the same talk that may be found online in a number of places, it’s always interesting to see the reaction of the people who attend. My guess is there were about 50-60 people there. While Gary noted there were few ‘white coats’ in the audience, I did notice more stethoscopes than white coats and the questions suggest the kind of crowd you’d expect to attend a “Grand Rounds.”

He warned the audience that he’d likely to go over. Even so, he appeared rushed in that he was trying to get through all all the slides in a reasonable amount of time. He spoke for a good hour & 15 – even with skipping a few of the the more involved topics towards the end of the presentation. Within a couple of hours after the presentation, the video from the talk was online and available for streaming. You may find it here (although, I did not get on camera, I did manage to get a couple of questions in during the Q&A period). Can’t say there was a general theme to all the questions posed, but there were some pretty narrowly-stated questions that surprised me a bit – about specific insulin response based on diurnal patterns or specific-meal insulin responses. The reason this surprised me is because the entire emphasis was on the cause of lipogenesis (fat accumulation) over a much broader window of time and what the causes of that lipogenesis might be. While it’s possible intra-day fluctuations might be a major cause, it seems highly unlikely.

One of the questions I posed was to inquire about Gary’s thoughts regarding Dr. Robert Lustig’s emphasis on fructose being the major culprit in the surge in world-wide obesity (marked increase in fructose consumption – sugar and HFCS – and a corresponding reduction in dietary fiber). I found that there have been talks between Gary and Dr. Lustig about writing a book together. That would be an interesting pairing, although my gut tells me Gary prefers to work alone.

While it’s a little unfair to deliver the presentation’s conclusions without all the supporting material, I do so here to encourage you to view it so you can be better educated and to be able to think more clearly and critically about the dietary guidance you do get.

Obesity is a disorder of fat accumulation, not energy balance (not overeating and sedentary behavior).

April 9, 2010

Readers of these pages know that if I were to point to one book and one author who most inspired me to take an entirely new look at nutrition and diet it’s Good Calories, Bad Calories by Gary Taubes. I touch on it on an early page I wrote for my blog, but I’m afraid I gave it short shrift. Why? Perhaps because I talk about it so much, I assumed I had written about it too, so let me explain.

No. There is too much. Let me sum up.

Gary Taubes is an award-winning science writer who, for years, has trained his sights on science that doesn’t pass his ‘sniff test’ and peeled away the layers of obfuscation, self-interest and cutthroat politics that often dominates science. Unlike the calm, rational, evidence-driven image we assume rules the roost when it comes to all matters of science, we find that (just like in any other human endeavor), sometimes that which can be objectively verified is superseded by orthodoxy, group-think and big money. As it turns out, this is especially true as it regards dietary science.

To put things the the proper context, it is exceedingly difficult to come to definitive, one-size-fits-all answers on dietary questions. There can be no blinded, controlled trials of different dietary approaches in the real world (hmm, I can’t tell, is this broccoli or an apple fritter I’m eating?). There are almost incalculable variables involved, so the certainty we strive for in science, is barely applicable to this field.

Yet and still, there has been a nutritional orthodoxy of which we are all familiar:

If you want to lose weight you have to burn more calories than you consume

Stay away from fat

A calorie is a calorie is a calorie (I think you get the picture).

In short, Good Calories, Bad Calories painstakingly and in astounding completeness and detail dismantles this dietary orthodoxy and leaves it like a steaming, quivering, gelatinous mass that cannot be reconstituted. The central tenets are:

Some calories are actually worse than others if your aim is to limit the amount of fat you store

Foods that quickly raise insulin levels prompts the body to store fat

Dietary fat (for various reasons) actually associates with a lower propensity to store fat in the body

I’m leaving a whole lot out, but I did say this was a ‘sum up.’ In the three years since GCBC was published, I have seen enormous changes. We are now starting to see more clinicians and researchers take these issues seriously and I’m actually starting to be hopeful for change. So to the real topic of this post.

The American Society of Bariatric Physicians and the Metabolism Society are sponsoring the “Western Regional Obesity Conference” in Seattle April 14-18, 2010. This is an amazing opportunity to hear some leading researchers speak on the many topics related to diet, nutrition and weight loss AND a great opportunity to get an update on Gary Taubes’ work. You will find Gary and many others cited in the program (PDF) for the event.

In addition to his appearance at the conference, he will also be delivering his lecture that lays out his obesity hypothesis in detail at both Swedish Medical Center and University of Washington Medical Center:

Why We Get Fat: Adiposity 101 and the Alternative Hypothesis of Obesity Date: Thursday, April 15